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Harm Reduction or Harm Promotion?

Marcos Susskind, Brazil

Harm Reduction a medical concept, a palliative in cases where a solution is impossible.  This term was “appropriated” by groups of drug use defenders– from groups favorable to the liberation of one or more psychoactive drugs to groups that believe “the fight against the drugs is lost, therefore, we must learn how to live with them”.  But a big part of the population does not accept the surrender to drugs, neither supports the liberation of their use – I believe those are the majority!  This group advocates that the term Harm Reduction was “stolen” from the medicine to bring ahead a harmful idea to future generations, a concept that rips the body of society, that injures the unit of the families and that stops fighting for the recovery of patients of the chemical dependence syndrome. Dr. Robert DuPont says that this policy might have some positive effect in chronic users, however it is devastating for the education and the prevention to the new generations. 

The best that can be done on the drug issue lies on three pillars:

• demand reduction

• supply reduction

• reduction of social mischief and health harm through treatment leading to drug abandonment and social reintegration

Drugs are part of society and will not cease to be.  This does not imply in accepting them.  The big question is: which are the policies that REALLY reduce the harm and increase the health of the individual as well as of the society?  Prostitution, murders, robberies and abuse of minors also exist since immemorial times and will never cease to exist.  Must we “close the eyes” and live with these behavior deviations?  We will accept “harm reduction” and teach shooting to murderers (avoiding them to kill passers-by).  Should we distribute boxing gloves to violent husbands so that their punches will be less harmful to their wives? 

In the 60’s Switzerland, using the so-called “harm reduction”, decided to offer heroin to heroin-dependents who refuse (or who are unable) to abandon their abusive use. England adopted this policy in 1976. The result: ten years later, in 1986, the Heroin users number in the England was multiplied by barely 100!  In 1976 there were 1,000 known users of Heroin.  In 1986 they were already 80,000 (Nahas G. – Toxicomania – Ed.  Masson – 1995). 

The strategy of the “Reductionists” is to change the concept, transforming the term from a medical word to a political program, making believe that “harm reduction” is the only valid instrument to face the question of toxicomania.  The tactic is to forget the consequences of drug use (apathy, anxiety, depersonalization, neurological degeneration, destruction of the family and of the social tissue, co-morbidities) and transform the use of drugs into something somewhat socially accepted.  They use ideas as  “individual rights”, “responsible use”, “autonomy of the user” and other.  But the truth is that the harm comes from the mere use, and the abuse of drugs is only a consequence of the use. 

They overstate the “right of the user” and they deny completely the “right of the non users”.  They fail to acknowledge the effects of the drugs that cause a tremendous deterioration of the social conduct, of family relationships, that increase criminality, marginalizing effects on the individual, loss of productivity and additional costs to the already exhausted health system. 

We struggle for prevention, for abstinence and we propose the social to this suicidal infamy, which we call “Harm Promotion”.  It is unjust to divert resources to promote harm in a country where so much of the population suffers without sustenance, medicines and healthcare and where there is even a lack of schools for our children.